Learning a new skill can be a challenging experience for most people, but especially for people with developmental disabilities such as autism. Autistic individuals grasp knowledge at a slower pace due to their cognitive and neurodevelopmental limitations. However, with the right therapy and assistance from a certified, behavioral specialist, they too can develop any skill or behavior required to lead better, independent lives.
While there are various types of therapy options available such as verbal training or occupational therapy, each targeting a different skill set, they all have one thing in common: prompts.
Prompts are used by therapists to help their patients or learners to arrive at the right answer or response in a given situation. Regardless of the type of therapy being used, prompts serve as signals for the learner to remember what they had learned their response should be and then execute it.
What is a Prompt in ABA?
In Applied Behavior Analysis or ABA, prompts are cues given to learners, such as people on the autism spectrum, before they respond to a stimulus, to guide the direction of their reaction.
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The goal of using prompts in ABA is to motivate individuals to respond appropriately to anything, but then eventually be able to execute that response to the same stimulus without any prompts or external assistance. This outcome is achieved with practice, patience, and most importantly: prompt fading.
When learning a new skill or response, it is crucial to associate the response with a stimulus and understand that prompts are just signposts along the way - they are not the stimulus or the cause that should bring out a certain response.
With fading, or in other words, the gradual decrease in prompting, people learn to dissociate these signposts from the situation so they are no longer necessary over time. Simply put, prompt fading reduces prompt dependency so people can carry out responses independently. To achieve this seamless transition from prompt dependency to independence, many therapists also employ techniques from errorless learning.
However, all prompts cannot be faded in the same way or frequency because there are many different types of prompts used in ABA. these prompts collectively form the prompt hierarchy. We’ll discuss this in more detail later, first, let's look at the different types of prompts used in ABA and how prompt fading works.
What does Prompt Fading Mean?
While prompts are useful teaching tools, it is important to remember that they must not be necessary forever. ABA prompt fading is just as significant as prompting to avoid the risk of prompt dependency. The ultimate goal of such behavioral therapies is independence, meaning an individual should be able to react or respond in a certain way without any guidance, hint, supervision, etc. Therefore, prompts must be “faded” or reduced over time so people can do without them after a while.
Difference between Stimulus and Prompts
While independence is the ultimate goal of therapy here, people still need some sign or cues to trigger a response. For example, carrying an umbrella when it rains or turning the lights on when it gets dark outside. These signals are natural cues and they are the stimuli behind the desired response; they must not be confused with prompts, which are accessory tools to encourage the right response. For example: telling someone to “say hello” when a new person enters the room to teach saying hello to new people without verbally reminding every time.
Types of Prompts Used in ABA
There are different types of prompts or cues used in therapy, such as verbal prompts or gestures. They range from intrusive to non-intrusive, and the type of prompt selected depends on various factors such as the skill level of the learner, their developmental age, which method they best respond to, etc. A certified therapist is the best person to navigate the different types of prompts to make the training sessions productive and effective. The table below shows the different types of prompts used in ABA therapy:
Prompt Hierarchy: The Pyramid of Help
All of the different types of prompts mentioned above lie on a scale which ranges from most intrusive to least intrusive. As you can see from the table, all prompts don’t offer the same type of assistance - some are hints, while others require more effort.
The hierarchy typically begins with the most invasive, direct prompts such as physical prompting then moves over to less invasive prompts such as indirect verbal prompts until independence is achieved.
There are two ways this hierarchy can be applied in ABA:
Most-to-least Prompting
This approach involves teaching a skill with the most intrusive response to ensure the individual learns the correct response. If the learner shows good progress, then the intrusiveness of the prompts is gradually decreased till they are no longer required.
The most-to-least approach is an effective way of teaching a task with a series of steps such as making a fruit salad, operating a dishwasher, or getting ready for school.
Least-to-most Prompting
As the name suggests, it is the opposite of the most-to-least approach. This one involves beginning with the least intrusive prompts to see whether further assistance is needed or not. If the learner does not show success, more intrusive prompts are used to help them learn the correct response.
For example, teaching an autistic person to sit down would involve the following prompts:
- Visual: Placing a chair next to the person
- Indirect verbal: Asking “Do you want to sit down?”
- Direct verbal: Saying “Please sit down”.
- Gestural: Pointing to the chair.
- Modeling: The instructor sits on the chair first to signal the child to also sit down.
- Partial physical: Propelling the child towards the chair.
- Full physical: Physically making the child sit down on the chair.
Which approach is selected or best suited for the individual is best gauged by a certified ABA therapist. As autism or developmental disorders are unique to each individual, there is no one-size-fits-all approach here. Therapists generally use a mix of different prompts and methods according to the skill level of the individual to achieve the best results.
Time Delay Prompting in ABA
Time delay prompting involves gradually increasing the time between the instruction and the prompt to encourage independent responses. This method helps learners with autism or developmental disorders to acquire new skills with minimal reliance on prompts.
Example of Time Delay Prompting
Teaching a child to identify a color (e.g., "red") using Constant Time Delay:
- Immediate Prompt Phase:
- Instruction: "What color is this?"
- Prompt: Immediately say "Red."
- Response: The child repeats "Red."
- Reinforcement: Provide praise or a reward for the correct response.
- Introduce Time Delay:
- Instruction: "What color is this?"
- Delay: Wait for 5 seconds.
- Prompt (if needed): Say "Red" if the child does not respond within 5 seconds.
- Response: The child says "Red."
- Reinforcement: Provide praise or a reward for the correct response.
- Increasing Independence:
- Gradually, the child begins to respond correctly before the prompt is given.
- Continue to reinforce correct independent responses and maintain the 5-second delay until prompts are no longer needed.
Conclusion
Prompting is an effective teaching tool to assist people with developmental disorder to learn the correct responses or new skills and successfully execute them when required to do so. The goal of prompting is enabling an individual to independently complete a task or an action, and therefore, it is paired with a technique called fading so people do not become dependent on prompts. The different types of prompts form a hierarchy ranging from most invasive to least invasive, assisting people in different ways till finally independence is achieved.
